Questioning Medicine

https://pubmed.ncbi.nlm.nih.gov/33734980/ if you lay flat with a blood draw you may have psuedoanemia https://jamanetwork.com/journals/jama/fullarticle/2782300 Men and UTI-- 7 days https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2782461 don't get a UA prior to a procedure for screening https://www.nejm.org/doi/full/10.1056/NEJMoa2026845 cardiogenic shock- dobutamine vs milri...

Yes this is a CME lecture but yes you get it for the expensive price of Free Fifty Free....

Contraception 2021 Sep 20;[EPub Ahead of Print], D Grossman, S Raifman, N Morris, A Arena, L Bachrach, J Beaman, MA Biggs, C Hannum, S Ho, EB Schwarz, M Gold STUDY DESIGN This is an interim analysis of an ongoing prospective cohort study conducted at five sites. Clinicians assessed patients in clinic and, if they were eligible for medication abortion and ≤63 days' gestation, electronically sent pr...

Davidson KW et al. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA 2021 Aug 24; 326:736. ( https://doi.org/10.1001/jama.2021.12531 )   The Task Force found moderate-certainty evidence that screening is beneficial for nonpregnant adults (age range, 35–70) who are overweight (i.e., body-mass index [BMI], ≥25 kg/m2) or obese (BMI, ≥30 kg...

I've found that I can often increase compliance with statins by having pt take them 3x/week or QOD.  I try this often especially in my secondary prevention group. I understand "any statin is better than none", but do data support this approach?   -- any is better than none! No rct with this but yes data supports every other day but that is observational.. what about vascepa in reducing CAD risk bo...

DYSh out information on DYSlipidemia: An Evidence-based Update on Cholesterol Management Please contact me for more information:    Andrew Buelt, D.O.  andrewbuelt@gmail.com Questioning Medicine Podcast Athrosclerotic Cardiovascular Disease Risk Calculator (ASCVD) 10 yr ASCVD risk calculator developed in 2013 ASCVD event defined as nonfatal myocardial infarction, coronary heart disease (CHD) death...

part 1-- you dont get the CME but you get the information

Podcast Gregory J, Huynh B, Tayler B, et al. High-dose vs standard-dose amoxicillin plus clavulanate for adults with acute sinusitis. A randomized clinical trial. JAMA Network Open 2021;4(3):e212713 Study design: Randomized controlled trial (double-blinded)  primary care offices with sinus symptoms consistent with currently accepted clinical criteria for acute bacterial sinusitis.  andomly receive...

Delay of Pregnancy Among Physicians vs Nonphysicians JAMA Intern Med 2021 May 03;[EPub Ahead of Print], MC Cusimano, NN Baxter, R Sutradhar, E McArthur, JG Ray, AX Garg, S Vigod, AN Simpson It has been hypothesized based on just rumor and people repeating it that women physicians are more likely to delay childbearing than nonphysicians. This population-based retrospective cohort study looked to se...

1) nurses commit more suicide and average population (doctors don't) 2) AK will turn in to SCC at a rate of about 2% per year 3) STOP SMOKING (even if you gain weight) 4) zofran is about equal to the rest for pregnant patients and the outcomes we care about 5) Tubes in the ear for children with acute otitis media?? It works about the same as medical management Association of US Nurse and Physician...

Donanemab doesn't work for alzheimers if you actually read the study. Mammograms should be done every other year and starting at age 50. Blue-blockers don't prevent eye strain on the computer and sleep varies but at this time the evidence doesnt suggest it causes obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2100708 new drug donanemab vs placebo = 257-patient double-blind randomised TRAILBLA...

Circulation Bariatric Surgery and Cardiovascular Outcomes in Patients With Obesity and Cardiovascular Disease: A Population-Based Retrospective Cohort Study Circulation 2021 Apr 13;143(15)1468-1480, AG Doumouras, JA Wong, JM Paterson, Y Lee, B Sivapathasundaram, JE Tarride, L Thabane, D Hong, S Yusuf, M Anvari Patients with CVD who underwent bariatric surgery were matched 1:1 with similar CVD pati...

Compression stocking to prevent cellulitis? NOT SO FAST! Vitamin D still doesn't work even for depression. Hip fractures are on teh decline and it is not because of drugs. A scribe cost money, but how much? What about doing an LP with anticoagulants, it is probably safer than you think. What do you do with kidney stones? Finally, there is a lot of medical waste, so stop ordering MRIs for low back...

1- make sure pts follow up on positive FIT test 2. symptom severity — driven particularly by catching/locking and clicking/popping — correlated significantly with the burden of cartilage damage. CARTILAGE DAMAGE!! 3. U.S. Food and Drug Administration announced it is allowing the use of the Binx Health Assay for point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae 4. In patient...

DOAC are just as safe if not safer for warfarin for valvular afib (NOT valve replacement but moderate to severe mitral stenosis). Please, just give normal lovenox for covid patients. Stop DM drugs in the elderly cause no-glycemia is more dangerous than hyperglycemia. semaglutide works as along as you keep taking it. gestational diabetes screening should be a two stop process. Effectiveness and Saf...

Uterine Fibroid and heavy bleeding might have a new drug if your normal drug was giving placebo. HPV Vaccine is still awesome and very very safe. Copper IUD has a new kid in town when it comes to emergency contraception and Colchicine should not be used for secondary prevention (at least not when I read the trial) HTTPS://WWW.NEJM.ORG/DOI/FULL/10.1056/NEJMOA2008283 Treatment of Uterine Fibroid Sym...

Part 2 of the top articles of 2020 1) statins and the nocebo effect 2) VA DOD Lipid guidelines- Don't check more than every 10 years! 3) blood in the urine and what to do about it per the newest guidelines. 4) SGLT2i, FLOZINS!!! The data and how to use it in practice with really really sick patients

A two part podcast on the top published articles of 2020

SGLT2 inhibitors and GLP1 agonists administered without metformin compared to other glucose‐lowering drugs in patients with type 2 diabetes mellitus to prevent cardiovascular events: A systematic review - Escobar - 2021 - Diabetic Medicine - Wiley Online Library Yes these fancy new drugs work with and without metformin but that does not mean these drugs should be first line!! Effect of a Single Hi...

Semaglutide works for weight loss but at what co$t? BOARD CHANGER- New gonorrhea guidelines Diabetes drugs are expensive for our patients and we can't forget that. Children find it hard to tell what facial expression you are giving when you have a mask on! https://www.nejm.org/doi/10.1056/NEJMoa2032183 industry-conducted trial published in the New England Journal of Medicine. Researchers randomize...

Also ask yourself, did this study compare their treatment to the 'gold standard' and if the answer is no they compared it to a straw man, then think big Pharma, or authors that needed publication for their job. We can't treat what we don't know exist and 30-50% of the time COVID19 is asymptomatic. Combined Oral Contraception DO NOT have an increase risk of DVT and long term the risk are very minim...

The Drug Addiction Treatment Act of Under the Act, physicians may apply for a waiver to prescribe buprenorphine for the treatment of opioid addiction or dependence outside of an opioid treatment program (OTP). The Drug Addiction Treatment Act of 2000 was authored by Senator Orrin Hatch (R-UT), Senator Joe Biden (D-DE), and Senator Carl Levin (D-MI). DATA 2000 waiver Why would biden reverse this—it...

Autoimmune mothers likely don't actually have more ADHD kids. If you patient is in the hospital we now have a RCT to answer the question about ACEI starting or stopping. Finally, there are problems around COVID we don't even know about and it has nothing to do with contracting COVID19. Association of Maternal Autoimmune Disease With Attention-Deficit/Hyperactivity Disorder in Children | Attention...

HHS Expands Access to Treatment for Opioid Use Disorder | HHS.gov U.S. Department of Health and Human Services Announcement of practice guidelines for the administration of Buprenorphine for treating opioid use disorders Jan 12- 20221 -physicians with a DEA license- only not all providers -you can only treat patients located in the state you have a medical license in (basically no tele) -Physician...

They say every dog has its day and IT think every drug has its place Anyone who says ‘that drug is bad’ or that test is bad or that anything is bad is just being closed minded or not aware of the evidence because evidence and medicine comes down to numbers. The real statement should be I don’t think that drug is beneficial enough for the harm. However that is an opinion statement, it is what you t...